Health Indicator Report of Diabetes: Gestational Diabetes

Why Is This Important?

Gestational diabetes is a type of diabetes in which high blood glucose levels (also known as impaired glucose tolerance) occurs during pregnancy in women who did not have diabetes before becoming pregnant.^1^ Gestational diabetes is usually diagnosed during the middle of pregnancy, between 24 to 28 weeks gestation, and usually goes away soon after delivery. Women who get gestational diabetes are often overweight before becoming pregnant or have a family history of diabetes. Gestational diabetes is more common in American Indian, Alaska Native, Hispanic, Native Hawaiian, Pacific Islander, and African American women, but also occurs in White women.^2^
Mothers with gestational diabetes are more likely to have large babies (over 9 lbs.), which may in turn lead to an increased risk of cesarean section delivery.^1^ Women who had gestational diabetes are at an increased risk for developing type 2 diabetes later in life.^3^ Infants born to women with gestational diabetes have a higher risk of developing diabetes and/or being obese.^3^ To reduce the risk of developing type 2 diabetes, pregnant women should get tested for diabetes 6 to 12 weeks after delivery and then every 1 to 3 years, stay physically active, eat a healthy diet, and maintain a healthy weight.^2^[[br]]
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Chart

Data Table

Data Notes

Notes

The BRFSS is a readily available source for estimating gestational diabetes prevalence for Alaska. Data from birth certificates and health records can provide more accurate estimates on the prevalence of gestational diabetes among pregnant women. Employment status is assessed by the question: "Are you currently ...?" with responses of "Employed for wages", "Self-employed", "Out of work for 1 year or more", "Out of work for less than 1 year", "A Homemaker", "A Student", "Retired", "Unable to work" or "Refused". Refusals are excluded.

Data Interpretation Issues

The Behavioral Risk Factor Surveillance System (BRFSS) is a readily available source for estimating gestational diabetes prevalence for Alaska. The BRFSS is a telephone survey of adults 18 and over. Information on background and methodology of the BRFSS managed by the Centers for Disease Control and Prevention (CDC) can be found at: [http://www.cdc.gov/brfss/]. The website for the Alaska BRFSS is: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx].
The question on gestational diabetes has been asked on the combined Standard and Supplemental BRFSS surveys since 2004.
Alaska Native people in analyses of the BRFSS refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals who indicate multiple races including American Indian/Alaska Native are considered Alaska Native in the data. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class.
This definition of the Alaska Native group is intended to conform to the eligibility requirements for access to Alaska Native Tribal Health Consortium health care services.
Post-stratification weights were used for Alaska prior to 2006; raking weights were used from 2007 onward. For more on this methodological change see: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/method.aspx].

Health Indicator Definition

Definition

Percentage of adult women 18 years of age and older who responded "Yes" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "Has a doctor, nurse, or other health professional ever told you have diabetes?" and is a female who responded "Yes" when asked, "Was this only when you were pregnant?".

Numerator

Weighted number of adult (18+) women who responded "Yes" on the BRFSS to the question: "Has a doctor, nurse, or other health professional ever told you have diabetes?" and is a female who responded "Yes" when asked, "Was this only when you were pregnant?".

Denominator

Weighted number of adult (18+) women with complete and valid responses on the BRFSS to the diabetes question, excluding those with missing, "Don't know/Not sure", or "Refused" responses.

Current Outlook

How Are We Doing?

The prevalence of gestational diabetes was 1.7% in 2017.
Gestational diabetes prevalence rates from the BRFSS are initially presented for all Alaskans and Alaska Native people for all available years. Subsequent analyses by demographic subpopulations (e.g., age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status) are limited to 2010 and later to allow for ease of assessing recent trends.
Crosstabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, and disability. Only the significant differences evident in contrasts by body mass index and disability are presented, but the other results are available upon request.
Gestational diabetes prevalence by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) three-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.

How Do We Compare With the U.S.?

In 2016, the prevalence rate for gestational diabetes for the U.S. was 0.9%, compared to 1.8% for Alaska. The recent prevalence rate for gestational diabetes in Alaska has been very similar to the national median obtained from the BRFSS.

Health Improvement Resources

What Is Being Done?

The Alaska Diabetes Prevention and Control Program supports participation in diabetes education for women with gestational diabetes. Diabetes education courses offer classes specific for people with type 1 diabetes, type 2 diabetes, or gestational diabetes.
Instructors, who are generally certified diabetes educators or registered dietitians, can help women with gestational diabetes control their blood glucose levels with diet and exercise and thereby reduce their likelihood of needing oral medications or insulin.

Evidence-based Practices

It is important to establish prenatal care during your first trimester (first 12 weeks) of pregnancy. Most women do not experience any signs or symptoms of gestational diabetes.
For more information, please contact the [http://www.diabetes.alaska.gov Alaska Diabetes Prevention and Control Program].

Available Services

Diabetes educators are skilled health professionals who can help women diagnosed with gestational diabetes optimize their pregnancy outcomes. Many physicians refer their patients with gestational diabetes to one of the diabetes education programs available in the state. Diabetes education programs may be accredited by the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE). The list of ADA-recognized diabetes education programs can be found at https://professional.diabetes.org/erp_list_zip. The list of AADE-accredited diabetes education programs can be found at https://www.diabeteseducator.org/patient-resources/find-a-diabetes-educator.
Information on gestational diabetes is available from the American Diabetes Association (ADA) at http://www.diabetes.org. A list of diabetes education classes in Alaska can also be found on the Alaska Diabetes Prevention and Control Program at http://dhss.alaska.gov/dph/Chronic/Pages/Diabetes/management.aspx.

The information provided above is from the Alaska Department of
Health and Social Services' Center for Health Data and Statistics,
Alaska Indicator-Based Information System for Public Health (Ak-IBIS)
web site (http://ibis.dhss.alaska.gov). The information published
on this website may be reproduced without permission. Please use
the following citation:
"
Retrieved
Sun, 15 September 2019
from Alaska Department of Health and Social Services, Center for
Health Data and Statistics, Alaska Indicator-Based Information
System for Public Health web site: http://ibis.dhss.alaska.gov
".

Content updated: Mon, 14 Jan 2019 13:59:29 AKST

The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published
on this website may be reproduced without permission. Please use the following citation:
"
Retrieved
Sun, 15 September 2019 2:21:23
from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information
System for Public Health Web site: http://ibis.dhss.alaska.gov/
".